Shoulder dislocation

Question 1

Why emergency?

Answer 1

1. Harder to reposition with time

2. Neurovascular injury

Question 2

Mechanism of injury

Answer 2

Abduction, external rotation and extension

Question 3

Clinical features of anterior dislocation

Answer 3

1. Shoulder pain
2. Arm held in slightly abduction and external rotation
3. Prominent acromion and humeral head
4. Axillary nerve
5. Shoulder flattening (humeral head)

• recurrent
• apprehensive test +ve
• relocation test +ve
• sulcus test +ve

Question 4

X-Ray

Answer 4

1. AP view: Overlapping humeral head and glenoid cavity
2. Axillary view: cannot do
3. Scapular Y view (Anteverted 20 degree anterolateral, at glenoid plane): Humeral head supposed to be on Y centre

Question 5

Reduction

Answer 5

1. Traction-counter traction
2. Kochers: associated with fracture of greater tuberosity, nerve injury
3. Stimpson: breathing difficulty due to pronation + midazolam
4. Hipporatic

Question 6

Posterior dislocation

Answer 6

• 5%
• fitting, convulsion
• electrocution
• rarely in trauma

Question 7

X-Ray

Answer 7

1. AP view: Light bulb appearance, distraction from glenoid rim
2. Scapular Y view: not central

Question 8

Inferior dislocation

Answer 8

• severe hyperabduction

- only in high traumatic injury?

Question 9

Anterior dislocation

Answer 9

1. Mechanism of injury
2. Recurrence
   3.

Question 10

Mx

Answer 10

1. Recurrence: can be warded?
2. Acute: cmr

younger get, more risk for recurrence